Percutaneous coronary intervention using new-generation drug-eluting stents versus coronary arterial bypass grafting in stable patients with multi-vessel coronary artery disease: From the CREDO-Kyoto PCI/CABG registry Cohort-3.

Autor: Hiroki Watanabe, Ko Yamamoto, Hiroki Shiomi, Takeshi Morimoto, Eri Kato, Yukiko Matsumura, Kenji Nakatsuma, Yasuaki Takeji, Hidenori Yaku, Erika Yamamoto, Yugo Yamashita, Yusuke Yoshikawa, Masayuki Fuki, Kyohei Yamaji, Natsuhiko Ehara, Hiroki Sakamoto, Kazuaki Imada, Takeshi Tada, Ryoji Taniguchi, Ryusuke Nishikawa, Tomohisa Tada, Takashi Uegaito, Tatsuya Ogawa, Miho Yamada, Teruki Takeda, Hiroshi Eizawa, Nobushige Tamura, Keiichi Tambara, Satoru Suwa, Manabu Shirotani, Toshihiro Tamura, Moriaki Inoko, Junichiro Nishizawa, Masahiro Natsuaki, Hiroshi Sakai, Takashi Yamamoto, Naoki Kanemitsu, Nobuhisa Ohno, Katsuhisa Ishii, Akira Marui, Hiroshi Tsuneyoshi, Yasuhiko Terai, Shogo Nakayama, Kazuhiro Yamazaki, Mamoru Takahashi, Takashi Tamura, Jiro Esaki, Shinji Miki, Tomoya Onodera, Hiroshi Mabuchi, Yutaka Furukawa, Masaru Tanaka, Tatsuhiko Komiya, Yoshiharu Soga, Michiya Hanyu, Kenji Ando, Kazushige Kadota, Kenji Minatoya, Yoshihisa Nakagawa, Takeshi Kimura, On behalf the CREDO-Kyoto PCI/CABG Registry Cohort-3 Investigators
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: PLoS ONE, Vol 17, Iss 9, p e0267906 (2022)
Druh dokumentu: article
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0267906
Popis: AimsThere is a scarcity of studies comparing percutaneous coronary intervention (PCI) using new-generation drug-eluting stents (DES) with coronary artery bypass grafting (CABG) in patients with multi-vessel coronary artery disease.Methods and resultsThe CREDO-Kyoto PCI/CABG registry Cohort-3 enrolled 14927 consecutive patients who underwent first coronary revascularization with PCI or isolated CABG between January 2011 and December 2013. The current study population consisted of 2464 patients who underwent multi-vessel coronary revascularization including revascularization of left anterior descending coronary artery (LAD) either with PCI using new-generation DES (N = 1565), or with CABG (N = 899). Patients in the PCI group were older and more often had severe frailty, but had less complex coronary anatomy, and less complete revascularization than those in the CABG group. Cumulative 5-year incidence of a composite of all-cause death, myocardial infarction or stroke was not significantly different between the 2 groups (25.0% versus 21.5%, P = 0.15). However, after adjusting confounders, the excess risk of PCI relative to CABG turned to be significant for the composite endpoint (HR 1.27, 95%CI 1.04-1.55, P = 0.02). PCI as compared with CABG was associated with comparable adjusted risk for all-cause death (HR 1.22, 95%CI 0.96-1.55, P = 0.11), and stroke (HR 1.17, 95%CI 0.79-1.73, P = 0.44), but with excess adjusted risk for myocardial infarction (HR 1.58, 95%CI 1.05-2.39, P = 0.03), and any coronary revascularization (HR 2.66, 95%CI 2.06-3.43, PConclusionsIn this observational study, PCI with new-generation DES as compared with CABG was associated with excess long-term risk for major cardiovascular events in patients who underwent multi-vessel coronary revascularization including LAD.
Databáze: Directory of Open Access Journals
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